Acceptability of a tablet-based application to support early HIV testing among men in rural KwaZulu-Natal, South Africa: a mixed method study

Abstract

Uptake of HIV testing remains low among men in South Africa. As part of a trial, we assessed the acceptability of a theoretically derived and adapted tablet-based-application (EPIC-HIV1) in rural South Africa. We conducted 20 in-depth interviews with men aged ≥18 years and offered a tablet-based survey to all men aged ≥15 years who received EPIC-HIV1 (Sep-Dec 2018). We conducted a descriptive analysis of the survey and used Self-Determination Theory (SDT) to guide our thematic analysis. A total of 232/307 (75%) completed the survey, 55% of whom were aged 15-24 years. 96%[ CI: 92.8-98.2%; n = 223] found EPIC-HIV1 acceptable and 77% [95% CI: 71.8-82.6%; n = 179] found it user-friendly. 222 [96%] reported that EPIC-HIV1 motivated them to test; 83% (192/232) tested for HIV, of which 33% (64/192) were first time testers. Those who did not consent (n = 40) were more likely to have had an HIV-positive test result. Participants reported that the app boosted their confidence to test. However, they were unsure that the app would help them overcome barriers to test in local clinics. Given reach and usability, an adapted SDT male-tailored app was found to be acceptable and could encourage positive health-seeking behavioural change among men.

Home‐Based Intervention to Test and Start (HITS): a community‐randomized controlled trial to increase HIV testing uptake among men in rural South Africa

“…Since HCT was offered right after the participants had listened to EPIC‐HIV, they might have not yet been ready to make immediate action towards HCT. Nevertheless, in the post‐intervention satisfaction surveys, 96% of participants who received EPIC‐HIV 1 found EPIC‐HIV 1 acceptable and motivated them to test, and almost everyone reported being empowered with the information from the app [40,41], suggesting that engagement with EPIC‐HIV 1 would potentially lead to better uptake of home‐based HIV testing or linkage to care in the future.…”

“…Since HCT was offered right after the participants had listened to EPIC-HIV, they might have not yet been ready to make immediate action towards HCT. Nevertheless, in the post-intervention satisfaction surveys, 96% of participants who received EPIC-HIV 1 found EPIC-HIV 1 acceptable and motivated them to test, and almost everyone reported being empowered with the information from the app [40,41], suggesting that engagement with EPIC-HIV 1 would potentially lead to better uptake of home-based HIV testing or linkage to care in the future. The overall population coverage of HIV testing during this single round of testing was relatively low at 21% (with 32% of men away from home at the time of the fieldworker visits and 33% choosing not to participate in the annual populationbased HIV testing), although over several rounds of testing, both the cumulative contact rate and the level of HIV testing would increase.…”

Engaging the ‘Missing Men’ in the HIV Treatment Cascade: Creating a Tailored Intervention to Improve Men’s Uptake of HIV Care Services in Rural South Africa: A Study Protocol

“…Once access has been granted, individuals need to navigate some pathways to access care, which requires an active response from the users [ 1 , 10 ]. We adopted the candidacy framework to elucidate some of the barriers identified in previous studies in our locality [ 1 , 5 , 6 , 11 , 12 ] and guide the development of a male-tailored intervention that will ease the pathway to accessing and engaging with HIV testing, treatment, and prevention services.…”

“…This explains the vicious cycle of HIV transmission and high incidence rate in the country, particularly in KZN, which needs urgent attention. To achieve zero new infections and zero AIDS-related deaths in our setting [ 6 ], there is a need to design an innovative intervention for men aiming at an early diagnosis and treatment pathway for those who are positive whilst those who are negative are encouraged to remain so to end the epidemic. Thus, the current study aims to co-create a tailored male-specific intervention using the participatory method to improve HIV testing and treatment uptake among men in rural KZN.…”

Blockchain and Artificial Intelligence Technology for Novel Coronavirus Disease 2019 Self-Testing

“…Mobile connected point-of-care diagnostics and self-testing has been successfully implemented in resource-limited settings [19][20][21]. However, there is limited evidence on the use of blockchain and AI technology for disease diagnosis.…”